MEDICARE: SORAYA LUGO SANTIAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	00000	PR
2	332H00000X	Eyewear Supplier
3	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1427180777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SORAYA LUGO SANTIAGO

Provider Business Mailing Address
First Line	:	8 CALLE BENITO FEIJOO
Second Line	:	URB VILLAS DEL ESTE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6900
Country	:	US
Telephone Number	:	787-765-4609
Fax Number	:	787-731-5642

Provider Business Practice Location Address
First Line	:	22 AVE WINSTON CHURCHILL LOCAL E009
Second Line	:	SENORIAL PLAZA
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6001
Country	:	US
Telephone Number	:	787-765-4609
Fax Number	:	787-765-4609

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	04/24/2025

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Directions to “ SORAYA LUGO SANTIAGO ” Practice Location

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